When Henry Miller was diagnosed with prostate cancer last summer, he immediately began researching his options. The Ewing native eventually decided to undergo treatment using a rapidly growing medical tool - robotic surgery.

"I'm a very active person, and I was concerned about being able to stay active," Miller said. "My research told me that robotic surgery was less invasive and had a faster recovery time."

Miller underwent a prostatectomy, the surgical removal of the prostate gland, at Trenton's Capital Health Regional Medical Center in September. His surgeon, Michael Cohen, used a da Vinci robot to perform the procedure.

The machine, which can range from $1 million to $2.25 million depending upon the model, has been hailed as a breakthrough in minimally invasive surgery. With its multiple remote-controlled arms and 3-D high-definition camera, it allows surgeons to operate through tiny incisions with more precision and visual clarity.

For the 26 New Jersey hospitals that have them, da Vinci robots can be a major draw. Patients like Miller will often seek out robotic surgery options after doing research.

"We do market some of the new technologies to the public," said Capital Health spokesperson Jayne O'Connor. "Patients have gotten quite savvy at finding new services that their doctors might not be aware of."

Some critics, however, point to problems that have arisen from inexperienced doctors using the machine.

A Wall Street Journal article in May highlighted the case of a botched operation with a da Vinci robot at a New Hampshire hospital. A follow-up story referred to a case in which a 42-year-old man died following robotic surgery last summer in Florida. An attorney for the man's family said the urologist who operated on him had never before performed the procedure he was attempting with the robot, according to the report.

"These articles highlighted important problems. We agree surgeons need more education. They need more support from the hospital," said urologist Vipul Patel, a world-renowned Florida-based surgeon who has performed about 4,000 prostatectomies with the da Vinci.

Surgeons receive half-day training by Intuitive Surgical (the company that makes the da Vinci) at their own hospitals before being sent to a two-day surgical-skills training session at one of da Vinci's 19 regional training centers. Following that, each hospital has its own credentialing standards.

"It's a very sophisticated piece of technology," said Ihor Sawczuk, chairman of the Hackensack University Medical Center Department of Urology. "Every hospital has their own criteria."

Some say that the absence of across-the-board credentialing standards leaves smaller hospitals, whose doctors perform less surgeries and thus get less experience with the machines, at a disadvantage.

Efforts are under way to remedy the issue -- the American Association of Gynecological Laparoscopists, the largest organization in the United States dealing with minimally invasive surgical issues, formed its own robotic committee this year with a goal of establishing uniform credentialing standards.

Sawczuk, who has performed close to 500 surgeries with the da Vinci system, was quick to point out that surgeons being trained to use the robot already understand how to perform the surgeries by hand.

"For an experienced urologic surgeon, a two-day course is sufficient," he said, noting that it takes about 20 to 25 cases to get the hang of the machine.

Miller, for one, is happy with his decision to undergo robotic surgery. He said he was out of the hospital the next day and almost fully recovered within three weeks.

For him, the skill and experience of the surgeon is much more important than the tools being used.

"I wasn't really concerned about the new technology," Miller said. "The input of a computer is only as good as the person at the keyboard."
The Orlando Sentinel contributed to this report.